ABSTRACT
The choice of treatment in locally advanced cervical carcinoma is a hot topic in the controversy of treatment for gynecology tumor.The three primary therapies for locally advanced cervical carcinoma are concurrent chemotherapy and radiotherapy,direct radical hysterectomy and operation after radiotherapy.This article mainly discusses several types of treatment and advises personalized treatment for locally advanced cervical carcinoma.
ABSTRACT
PURPOSE: To evaluate the patterns of tumor shape and to compare tumor volume derived from simple diameter-based ellipsoid measurement with that derived from tracing the entire tumor contour using region of interest (ROI)-based 3D volumetry with respect to the prediction outcome in cervical cancer patients treated with concurrent chemotherapy and radiotherapy. MATERIALS AND METHODS: Magnetic resonance imaging was performed in 98 patients with cervical cancer (stage IB-IIIB). The tumor shape was classified into two categories: ellipsoid and non-ellipsoid shape. ROI-based volumetry was derived from each magnetic resonance slice on the work station. For the diameter-based surrogate "ellipsoid volume," the three orthogonal diameters were measured to calculate volume as an ellipsoid. RESULTS: The more than half of tumor (55.1%) had a non-ellipsoid configuration. The predictions for outcome were consistent between two volume groups, with overall survival of 93.6% and 87.7% for small tumor ( or =40 mL) using ROI and diameter based measurement, respectively. Disease-free survival was 93.8% and 90.6% for small tumor, 54.3% and 62.7% for intermediate-size tumor, and 13.7% and 10.3% for large tumor using ROI and diameter based method, respectively. Differences in outcome between size groups were statistically significant, and the differences in outcome predicted by the tumor volume by two different methods. CONCLUSION: Our data suggested that large numbers of cervical cancers are not ellipsoid. However, simple diameter-based tumor volume measurement appears to be useful in comparison with ROI-based volumetry for predicting outcome in cervical cancer patients.
Subject(s)
Humans , Disease-Free Survival , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Magnetics , Magnets , Tumor Burden , Uterine Cervical NeoplasmsABSTRACT
Objective To observe the clinical effect of gemcitabine combined with nedaplatin concurrent chemotherapy and radiotherapy in treatment of advanced nasopharyngeal carcinoma.Methods Seventy-six advanced nasopharyngeal carcinoma patients were divided into observation group(38 cases)and control group(38 cases)by radom digits table.The patients in observation group were treated with gemcitabine combined with nedaplatin concurrent chemotherapy and radiotherapy.The patients in control group were treated with fluorouracil combined with cisplatin concurrent chemotherapy and radiotherapy.The clinical effect and adverse reaction were compared between two groups.Results The total effective rate in observation group was 84.2％(32/38),which significantly higher than that in control group[60.5％(23/38)](P＜0.05).There was no significant difference in 1 year overall survival rate between two groups[89.5％ (34/38)vs.76.3％(29/38)](P ＞ 0.05).The rate of gastrointestinal reactions and oral ulcers in observation group were 42.1％(16/38)and 7.9％(3/38),which significantly lower than those in control group[73.7％ (28/38),31.6％(12/38)](P ＜ 0.05).The rate of bone marrow suppression between two groups had no significant difference[31.6％(12/38)vs.23.7％(9/38)](P ＞ 0.05).Conclusion Gemcitabine combined with nedaplatin concurrent chemotherapy and radiotherapy in treatment of advanced nasopharyngeal carcinoma can enhance the clinical effect,and decrease the adverse reaction,which can be applied in clinic.